Clearing the Air of CFCs

The end is near for CFCs used in inhalers.

HFA albuterol inhalers will probably
cost three times more than the generic CFC-propelled inhalers that more than 50 million people use now.

In the late 1970s, when the depletion of the ozone layer was talked about as much as global warming is today, governments across the world began to ban the use of chlorofluorocarbons (CFCs), an ozone-depleting propellant, in aerosol products such as hairspray and air fresheners. The rules fell short, though, of banning the propellant from the inhalers that asthmatics use until suitable alternatives could be found. As a result, the most common inhalers used to treat asthma today still contain CFCs.

That will change starting Jan. 1, 2009, when the propellant hydrofluoroalkane (HFA) will replace the CFCs used in albuterol inhalers. Research has shown that HFA works as well as CFCs in delivering the drug. Dr. Leslie Hendeles, a University of Florida professor of pharmacy and pediatrics, notes that some patients might struggle getting used to it, however. “They differ in how they feel and taste,” Hendeles says. “Some people get the impression that it doesn’t work as well or they don’t like it, but, in blind scientific studies, it produces the same relaxation of the airways that products containing CFCs do.”

Because generic versions of HFA won’t be available until 2012, the cost of HFA albuterol inhalers will probably be three times more than the generic CFC-propelled inhalers sold now. A study, published this year in the New England Journal of Medicine, estimated that the uninsured will spend $312 a year more for the non-generic, HFA version. Hendeles, who helped conduct the study, says even patients with prescription benefits will probably spend more in the form of higher co-pays.